New York State Assemblyman Richard Gottfried, who represents the Chelsea and Hell's Kitchen sections of Manhattan (D-75th District), has introduced a bill to implement a true single-payer healthcare system in New York State. Although the legislation made it out of the healthcare committee of the Assembly last year, it then was basically stonewalled from going much further.

Gottfried, chair of the health committee, told BuzzFlash at Truthout, the bill was re-introduced at the beginning of this session on January 8th of 2014.

What makes Gottfried's bill distinct is that it would -- if implemented in its ideal configuration -- be a true single-payer healthcare system for all New Yorkers (except Veterans, who receive care through a government-administered system of providers employed by the Veterans Administration.)

This differs from what is called the Vermont "single-payer" system, which is a laudable one coming down the pike. But the Vermont healthcare insurance program would more accurately be called a comprehensive coverage system than a true single-payer.

Gottfried's bill (A5389-A/S2078-A) would create the New York Health Trust Fund and all New Yorkers -- in theory -- (except veterans) would eventually receive care through the fund. They would carry a "New York Health" card for all their medical needs. Although still far from being enacted, what would make Gottfried's bill a near seamless single-payer, if passed and implemented in its ideal form, is that the federal government would (and that is something, alas, unlikely to see for the time being given current DC private insurance control of politicians) pay Medicare and other federal programs directly into the state health insurance program. (Medicaid is already paid to states to administer the program within each state -- but Gottfried's bill would make Medicaid party of the pool of money funding "New York Health.") There are still some gaps and exceptions that would be closed at a later time were the bill ever to be passed and the feds were to provide waivers, but it puts the first stage of a state single-payer on the map of consideration even if it is a political long shot.

Here is the key paragraph (in section 2 of the bill) that makes Gottfried's bill such a milestone in setting the bar on state single-payer:

It is the intent of the Legislature to create the New York Health program to provide a universal health plan for every New Yorker, funded by broad-based revenue based on ability to pay. The state shall work to obtain waivers relating to Medicaid, Family Health Plus, Child Health Plus, Medicare, the Patient Protection and Affordable Care Act, and any other appropriate federal programs, under which federal funds and other subsidies that would otherwise be paid to New York State and New Yorkers for health coverage that will be equaled or exceeded by New York Health will be paid by the federal government to New York State and deposited in the New York Health trust fund. Under such a waiver, health coverage under those programs will be replaced and merged into New York Health, which will operate as a true single-payer program.

Gottfried admitted to BuzzFlash at Truthout that passage of the bill is going to be a long haul, but that he wants to set a marker down to put the idea into play on the state level: "I'm realistic enough to understand that this an uphill fight and not for the faint-hearted. Going up against the insurance industry is a major challenge. The federal government is not ready for a single-payer system. If the federal government is not cooperative, we will work toward a first step of wrap-around coverage, similar to the Medicare Advantage program."

In the news release put out by Gottfried's office when the single-payer bill was first introduced, it stated succinctly: "The New York Health program would provide comprehensive, universal health coverage for every New Yorker and would replace private insurance company coverage."

A key point about single-payer is quite cogent and compelling as made by Gottfried: that "the most affordable way to achieve universal coverage," as confirmed in a report by New York State "found that a single-payer plan would have the lowest-cost for providing universal coverage, compared to plans relying on insurance companies and employment-based coverage."